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接受确定性肠切除术的克罗恩病患者术后手术部位感染的危险因素。

Risk factors for postoperative surgical site infections in patients with Crohn's disease receiving definitive bowel resection.

机构信息

Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.

Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China.

出版信息

Sci Rep. 2017 Aug 29;7(1):9828. doi: 10.1038/s41598-017-10603-8.

Abstract

Surgical site infection presents as a significant problem that limits the potential benefits of surgical interventions. This study is to investigate risk factors for postoperative SSI in patients with Crohn's disease receiving definitive bowel resection. A case-control study including 49 patients with SSI and 105 patients without SSI was performed. Demographics, clinical characteristics, laboratory information, medical and surgical data were compared between groups. Significant elements were subsequently brought into logistic regression analysis for further identification. Patients with SSI exhibited higher tobacco usage rate (p = 0.03), lower preoperative hemoglobin (p = 0.02) and pre-albumin level (p = 0.02). Bowel penetration instead of stricture was more frequent in patients with SSI (p = 0.04). Longer duration of operation (p = 0.03) and higher intraoperative lactate level (p = 0.02) were observed in patients with SSI. Logistic analysis identified that preoperative pre-albumin (95% CI: 0.20.7; OR = 0.5; p = 0.03), duration of operation (95% CI: 2.39.5; OR = 3.8; p = 0.03) and intraoperative lactate level (95% CI: 1.7~7.2; OR = 3.4; p = 0.04) were associated with postoperative surgical site outcome. Our data has identified that lower preoperative pre-albumin, longer duration of operation and higher intraoperative lactate level are risk factors for SSI in patients with Crohn's disease receiving definitive bowel resection.

摘要

术后手术部位感染是一个严重的问题,限制了手术干预的潜在益处。本研究旨在探讨接受确定性肠切除的克罗恩病患者术后手术部位感染(SSI)的危险因素。进行了一项包括 49 例 SSI 患者和 105 例无 SSI 患者的病例对照研究。比较了两组患者的人口统计学、临床特征、实验室信息、医疗和手术数据。随后将显著因素纳入逻辑回归分析,以进一步确定。SSI 患者的吸烟率更高(p=0.03),术前血红蛋白(p=0.02)和前白蛋白水平(p=0.02)更低。SSI 患者的肠穿透而非狭窄更为常见(p=0.04)。SSI 患者的手术时间更长(p=0.03),术中乳酸水平更高(p=0.02)。逻辑分析确定术前前白蛋白(95%CI:0.20.7;OR=0.5;p=0.03)、手术时间(95%CI:2.39.5;OR=3.8;p=0.03)和术中乳酸水平(95%CI:1.7~7.2;OR=3.4;p=0.04)与术后手术部位结局相关。我们的数据表明,术前前白蛋白水平较低、手术时间较长和术中乳酸水平较高是接受确定性肠切除的克罗恩病患者发生 SSI 的危险因素。

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PLoS One. 2020 Oct 28;15(10):e0240995. doi: 10.1371/journal.pone.0240995. eCollection 2020.

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